tbuckley/cabot-search huggingface dataset:
Abstract P329: Eicosanoids and Heart Failure Risk in the Atherosclerosis Risk in Communities (ARIC) Study
Authors: Ngoc Quynh Nguyen, Yueh-Ning Yang, Mona Alotaibi, Huaizhu Wu, Ron C Hoogeveen, Christie M Ballantyne, Amil M Shah, Tao Long, Mohit Jain, Susan Cheng, Bing Yu
Journal: Circulation (2023)

Introduction: Eicosanoids play an important role in regulating inflammation response, which influences the development of heart failure (HF). However, the association between eicosanoids and the risk of HF remains unclear. Hypothesis: We hypothesize that eicosanoid metabolites are associated with incident HF and may improve HF prediction. Methods: We measured plasma eicosanoids via liquid chromatography-mass spectrometry among HF-free participants at visit 2 (1990-1992) from the Atherosclerosis Risk in Communities (ARIC) study. The Cox proportional hazard regression was performed to evaluate the relationship between eicosanoids and incident HF controlling for clinical risk factors. The least absolute shrinkage and selection operator was applied to identify a representative subset of eicosanoids towards constructing an eicosanoid risk score (ERS). We further conducted genome-wide association analyses to examine the genetic determinants for HF related eicosanoids in black and white participants respectively. Results: During an average of 21 years of follow up, 2,202 (28.0 % blacks, 50.3% women) out of 9,519 participants developed HF. Out of 200 eicosanoids analyzed, six with hazard ratio between 0.89 to 1.10 were found associated with the risk of HF (FDR &lt;0.05) per SD change, namely 11-dehydro-2,3-dinor-TXB2, 5-hydroperoxyicosa-6,8,11,14,17-pentaenoic acid, 13-hydroperoxyoctadeca-9,11-dienoic acid, eicosapentaenoic acid (EPA) [M-H], and EPA [M-H+Acetate]. Genetic loci were identified for six HF related eicosanoids (p&lt;8.3e-9). One locus, rs6600888, an intronic variant of UGT2B7 , where its T allele was associated with lower EPA [M-H+Acetate] level while positively affect the risk of HF and systolic blood pressure level. ERS constructed from 52 eicosanoids showed a 39% increase in HF risk per SD increment and twice the risk between the highest and the lowest ERS quartile (p &lt; 0.001). The addition of ERS to the HF 10-years prediction model modestly improved the C-statistics from 0.799 to 0.808, 95%CI ΔC : 0.004-0.015. Conclusion: We identified a set of eicosanoids that significantly associated with increased risk of HF. The contributing genetic variation of eicosanoids may depict the biological pathways related to HF.
Abstract MP43: The Role of the Physical Environment in Racial Differences in Sleep Duration
Authors: Dayna A Johnson, Krysta Medearis, Kari Moore, Susan Redline
Journal: Circulation (2023)

Background: Racial and ethnic sleep disparities have been documented; however, the mechanisms are unclear. The physical environment is associated with sleep duration and may explain sleep disparities. We examined the physical environment as a mediator of racial differences in sleep duration using data from the Multi-Ethnic Study of Atherosclerosis (N=2073). Methods: Participants underwent 1-week actigraphy, completed questionnaires on the neighborhood environment, and addresses were geocoded and linked to physical environment features. Actigraphy-measured sleep duration was analyzed as both continuously and categorically (short sleep duration &lt; 6 hours vs. ≥ 6 hours). Physical environment characteristics included availability of healthy foods, aesthetic quality, walking environment, walking destination density, the proportion of land dedicated to retail space and an overall built environment score. Multi-level linear and Poisson regression models with robust variance were fit to examine associations of race, physical environment, and sleep duration with adjustment for covariates. Direct and indirect mediation was tested via path models. Results: The mean age was 68.6 ± 9.2 years. Approximately 46% of participants were male and 37.7% White, 27.7% Black, 23.1% Hispanic, and 11.5% Chinese American. The prevalence of short sleep (6 hours) was highest for racial minorities, ranging from 32.2% to 44.3% compared to 19.2% for White adults. A higher built environment factor score was associated with shorter sleep duration. The physical environment partially mediated racial disparities in sleep duration between Hispanic and White adults. A significant indirect effect of race on sleep duration via aesthetic quality, walking destination density, proportion retail and the built environment factor score was detected, explaining 4.0%, 27.2%, 7.6%, and 37.8%, respectively of the association between race and sleep duration for Hispanic individuals, compared to White individuals. The physical environment did not explain the Black-White or Chinese-White disparity in sleep duration. Conclusion: Black, Hispanic, and Chinese individuals had shorter sleep duration than White individuals. The Hispanic-White disparity in sleep duration was partially explained by the physical environment. These findings suggest that the physical environment may be an important mechanism in which racial disparities in sleep exist and a likely a target for intervention.
Abstract P114: Revisiting the Impact of Obstructive Sleep Apnea (OSA) on Cardiovascular Disease and Outcomes
Authors: Yaser Khalid, Kirti Dasu, Neethi Dasu, Fizan Khalid, Bhavana Kadiyala, Rohan Umrani
Journal: Circulation (2023)

Background: Previous studies have shown a direct correlation between having obstructive sleep apnea (OSA) and developing cardiovascular disease. Patients with OSA and cardiovascular disease also have higher morbidity and mortality. However, randomized trials have not shown an improvement in cardiovascular outcomes if OSA is better controlled and treated. For this study, the aim was to revisit the impact of OSA on cardiovascular outcomes using a large database. Methods: The Nationwide Inpatient Sample (NIS) is the largest publicly available inpatient database designed to provide information on characteristics and outcomes of patients discharged from US hospitals. The National Inpatient Database (NIS) was sampled using ICD-10 codes for patients (&gt; age 18) with OSA and cardiovascular diseases, which included coronary artery disease (CAD), hypertension (HTN), cerebrovascular accident (CVA), acute myocardial infarction (AMI), peripheral vascular disease (PVD), diabetes, versus patients with only OSA. Data was extracted from 2015 to 2020 and various parameters were analyzed using propensity matching utilizing the Kernel Method. Multivariate logistic regression was used to adjust for confounders. The primary outcome was mortality. Secondary outcomes were hospital length of stay (LOS) and total hospital charges (TOTCHG). Results: This study included 11,701,550 patients had OSA of which there were 4,061,025 with CAD, 1,842,025 with diabetes, 3,677,950 with CHF, 3,257,950 with cardiac arrhythmias, 152,100 with CVA, 339,000 with AMI, 328,300 with PVD, and 4,276,200 with HTN. Patients with OSA and CVA (OR 4.80, CI 4.30-5.37, p&lt;0.0001), AMI (OR 2.67, CI 2.44-2.91, p&lt;0.0001), and cardiac arrhythmias (OR 2.33, CI 2.27-2.40, p&lt;0.0001) had increased mortality compared to those with only OSA. Those with OSA and CVA had higher hospital LOS ( +2.24 days, CI 1.99-2.51, p&lt;0.0001). Finally, patients with OSA and CHF ($1,701, CI $687-$2,715, p&lt;0.0001), cardiac arrhythmias ($15,393, CI $14,152-$16,634, p&lt;0.0001), CVA ($39,339, CI $34,640-$44,037, p&lt;0.0001), and AMI ($36,984, $34,099-$39,870, p&lt;0.0001) increased TOTCHG. Conclusion: Based on our study results, cardiovascular diseases (CVD) such as AMI, CVA, and arrhythmias had significantly increased mortality, hospital LOS, and TOTCHG in patients with OSA. There is still a direct correlation between certain cardiovascular diseases and OSA. Our study shows increased morbidity and mortality as well in this patient population. Thus, OSA remains an important risk factor in CVD and new randomized trials are required to further study the relationship between OSA and cardiovascular disease in order to mitigate and prevent adverse hospital outcomes.
Abstract P559: Evaluating Geographic Variation in Hypertension in Urban Haiti: Findings From the Haiti Cardiovascular Disease Cohort Study
Authors: Rehana Rasul, Vanessa Rouzier, Lily D Yan, Rodney Sufra, Shalom Sabwa, Nour Mourra, Marie Deschamps, Jean Pape, Denis Nash, Margaret Mcnairy
Journal: Circulation (2023)

Introduction: Hypertension (HTN) is the leading cardiovascular risk factor in low-income countries including Haiti. Understanding blood pressure (BP) variation at the individual, neighborhood and population levels may help target interventions for multi-level risk reduction. This study aims to identify systolic BP (SBP) and diastolic BP (DBP) variation by neighborhood census blocks in Port-au-Prince to determine if this level should be targeted for future HTN interventions. Methods: Using data from the Haiti Cardiovascular Disease Cohort (March 2019-August 2021), a population-based cohort of Haitians ≥ 18 years, HTN was defined as SBP ≥140 mmHg or DBP ≥80 mmHg. Census blocks were defined as geographic areas of approximately 100-200 residential buildings per the Haitian Institute of Statistics. The geographic distribution of SBP and DBP was mapped based on household location. The proportion of SBP and DBP variation in block membership was calculated using intra-class correlations (ICC) from linear mixed models. Results: Among 2,972 participants, median (IQR) age was 40 (28-55) years and 57.6% were female. HTN prevalence was 33.0% and median (IQR) SBP and DBP were 120 (108-140) mmHg and 73.0 (64.0-85.0) mmHg, respectively. No distinct geographic pattern was present for SBP or DBP across blocks (Figure 1). The variation of SBP was 0.7% and DBP was 1.0% across census block membership. Conclusion: HTN prevalence in urban Port-au-Prince is high without a significant variation in SBP and DBP by census block. This may be due to outdated census data, crossover of individuals living informally across households, and/or the need for different household-level neighborhood geographic constructs such as shared household units. Moreover, these data suggest that interventions may need to target the population level, which span neighborhoods, given the uniformity of hypertension across these communities in Port-au-Prince.
Abstract P435: Proton Pump Inhibitor Use and Risk of Incident Primary Cardiovascular Disease: A Systematic Review and Meta-Analysis
Authors: Ahmed I Soliman, Jean Wactawski-Wende, Amy E Millen, Charles B Eaton, Shelly L Gray, Michael J Lamonte
Journal: Circulation (2023)

Background: The risk of secondary cardiovascular events associated with proton pump inhibitor (PPI) use and their interaction with thienopyridine antiplatelets such as clopidogrel is well established. Recent evidence from in-vitro and animal studies suggests PPIs may impact cardiovascular disease (CVD) irrespective of antiplatelet use. However, whether PPI use is associated with primary cardiovascular events in humans remains uncertain. Methods: Systematic searches were conducted in the MEDLINE and EMBASE databases from their inception to September 2022. Inclusion criteria included studies that examined participants free from cardiovascular disease at baseline who were followed over time to assess any of the following outcomes according to PPI use: incident myocardial infarction (MI), incident ischemic stroke (IS), or CVD mortality. Hazard ratios (HR) and their 95% confidence intervals (CI) were abstracted, combined estimates and heterogeneity (I 2 ) were calculated using the random-effects model in RevMan 5.4 software. Results: A total of 15 observational studies met the inclusion criteria, 2,272,479 participants were studied for MI, 2,689,943 for IS, and 1,591,428 for CVD mortality. The mean age of participants ranged from 49.3 to 82.2 years. Compared to non-use, PPI use was associated with 30% higher risk of incident MI (HR: 1.30, 95%CI: 1.10-1.53, I 2 =91%) and 15% higher risk of CVD mortality (HR: 1.15, 95%CI: 1.05-1.26, I 2 =56%). However, there was no statistically significant association with incident IS (HR: 1.05, 95%CI: 0.91-1.22, I 2 =96%). Conclusion: The meta-analysis results from published studies suggests PPI use is associated with higher risk of incident MI and CVD mortality. However, these findings should be interpreted with caution given the considerable heterogeneity among published studies and the possibility of residual confounding. More studies are needed to address these limitations and determine the validity of these associations.
Abstract MP38: Higher Childhood Cardiovascular Risk Score is Associated With Worse Physical, Social and Emotional Functioning in Adulthood
Authors: Jessica G Woo, Lydia A Bazzano, Elaine M Urbina
Journal: Circulation (2023)

Introduction: Childhood cardiovascular risk factors have been associated with increased risk of adult cardiovascular disease, but how they are associated with adult physical, emotional and social functioning is not well understood. Hypothesis: We addressed the hypothesis that the International Childhood Cardiovascular Cohort (i3C) Consortium childhood risk score would be associated with worse physical, social and emotional functioning in adulthood. Methods: The i3C childhood combined risk score is the average of five childhood risk factors (body mass index, systolic blood pressure, youth smoking, total cholesterol and triglycerides) on the z-score scale. Self-reported measures of physical (e.g., pain, functioning, fatigue), social (e.g., social isolation, satisfaction with social role) and emotional functioning (e.g., anxiety, depression) were assessed in adulthood in a subset of two i3C cohorts, the NHLBI Growth and Health Study (NGHS) and the Princeton Lipid Research Study (PLRS). Potential covariates included cohort (as a proxy for age, given no overlap in ages between cohorts), sex, race (Black vs. White), own education, parental education, marital status, and self-reported hypertension, diabetes and cancer. Interactions between the i3C risk score and cohort (age) were evaluated. Results: Ninety-two NGHS (100% female, 46% Black, mean±SD age 44.5±0.6 years) and 75 PLRS (77% female, 31% Black, 60.6±3.4 years) participants were included in analyses. In adjusted models, a higher i3C risk score was associated with worse physical functioning, global pain score, pain interference with everyday activities, and fatigue in the older PLRS participants, but only with global pain score in the younger NGHS participants (all p[int]&lt;0.05 except global pain). Higher i3C childhood risk score was associated with greater sleep-related impairment in PLRS, but with less impairment in NGHS participants (p[int]=0.03). Higher i3C childhood risk score was also associated with higher depression scores and less satisfaction with social roles in PLRS participants but not NGHS participants (p[int]=0.02 and 0.04, respectively). There was no significant relationship of i3C risk score with sleep quality, friendships, social isolation or anxiety. Conclusions: In conclusion, higher childhood cardiovascular risk factors are associated with worse physical, social and emotional health in adulthood, even in this limited sample of predominantly Black and White women followed from childhood. These effects are more prominent in older than younger adults, when issues such as pain and sleep problems become more prevalent.
Abstract P589: Utilization of Pulmonary Artery Sensor (CardioMEMS Device) During the Sars-CoV-2 Pandemic
Authors: Amer Muhyieddeen
Journal: Circulation (2023)

Introduction: The implantation of wireless pressure monitoring devices has allowed remote monitoring of hemodynamic data in patients with congestive heart failure. Devices such as the (CardioMEMS HF System) achieve this by remotely monitoring changes in pulmonary artery pressure, which has been shown to be a signal of worsening heart failure. The benefits of wireless pressure monitoring devices in reducing mortality and hospitalizations have been shown in clinical trial data. However, the impact of the COVID-19 pandemic on its use has not been studied. The aim of this study was to examine if the COVID-19 pandemic led to gender and race differences in in-hospital outcomes, length of stay, and total hospital charges in pulmonary artery sensor insertion. Methods: Data was extracted from the National Inpatient Sample database for the calendar year 2020. Patients implanted with a wireless pressure monitoring device were identified using relevant International Classification of Disease, and Clinical Modification codes. The study sample was stratified based on gender and race. The key outcomes of length of stay, total hospitalization cost, and mortality were then accessed. Results: A total of 485 patients were included in the final analysis. The mean age was 66.3 years, 32% (155 of 485) were female and 70% (340 of 485) were Caucasian. The overall inpatient mortality rate was 3.09% (15 of 485), 76.2% (370 of 485) of admissions were non elective, mean length of hospitalization was 14.87 days and mean total hospital charges was 349,599 US dollars. We found no association between differences in mortality rates between both gender and race. Regarding total hospital charges, there was a significant less amount of total hospital charges for females (P&lt;0.05) but not between races. There was no significant difference between length of hospital stay for gender or race. Conclusion: Analysis of this large database of patients undergoing wireless pressure monitoring device implantation suggests that in-hospital mortality and length of stay were comparable in both gender and race during the first year of COVID-19 pandemic. However, females had a significantly less amount of hospital charges. Our study suggests that further randomized data is needed to fully assess gender disparities in patients implanted with wireless pulmonary artery pressure devices.
Abstract MP57: Coagulation Factor IX and Incident Diabetes Risk: The REasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Authors: Megan Zhou, Katherine Wilkinson, Timothy B Plante, Debora Kamin Mukaz, D. Leann Long, Neil A Zakai, Mary Cushman, Nels C Olson
Journal: Circulation (2023)

Introduction: A prothrombotic state is implicated in the vascular complications of type 2 diabetes (DM), and such complications disproportionately affect Black compared to White adults. However, it is not known if this is due to DM or whether coagulation factor levels are related to DM incidence. Higher coagulation factor IX (FIX) was related to increased risk of CHD and stroke among Black but not White participants in the REGARDS cohort. We hypothesized higher FIX antigen would be associated with incident DM risk, with stronger relationships in Black versus White adults. Methods: REGARDS enrolled 30,239 Black and White adults from across the contiguous US from 2003-2006 with a second in-home visit from 2013-2016. The Biomarkers as MEDiators of Racial Disparities in Risk Factors (BioMedioR) nested cohort study included 4,400 participants who completed both visits, balanced on race and sex. Modified Poisson regression models estimated the RR of incident DM per 1-SD increment log FIX. We tested for a FIX-by-race interaction a priori due to differential associations of FIX with CHD and stroke by race in REGARDS. Results: Among 3,381 participants without baseline DM (mean age 63 years, 44% Black race, 51% women), 456 (13.5%) developed incident DM over 9.5-years. Adjusting for age, sex, and race, there was a significant difference in the association of FIX with DM by race (p-interaction&lt;0.01). As shown in the Figure, adjusted for age and sex (Model 1), the RR (95% CI) for incident DM was 1.19 (1.05, 1.34) for Black adults and 1.49 (1.23, 1.81) for White adults. Adjusting for clinical risk factors (Model 2) fully attenuated this association for Black adults, and further adjusting for behavioral factors (Model 3) fully attenuated this association for Black and White adults. Conclusions: Higher FIX levels were associated with incident DM risk. Relationships between FIX and incident DM were stronger for White than Black adults. The FIX-DM association may be due to adverse clinical and behavioral risk factors.
Abstract P566: Prevalence of Renal Failure in a Young Community-Based Sub-Saharan African Population
Authors: Al Haaj Madické Diack, Bamba Gaye, Audrey Geoffroy, Awa Ba, Mor Diaw, Ibrahima Bara Diop, Xavier Jouven, Sidy M Seck
Journal: Circulation (2023)

Background: Patients with renal failure have a higher risk or cardiovascular events. However, the prevalence of renal failure in Sub Saharan Africa communities remain poorly documented. Methods: Data were collected between March and April 2013 from 3 regions of the Northern Senegal (i.e., Saint-Louis, Matam et and Louga) using a cluster sampling method and the survey base of the national statistical and demographical agency subjects aged between 18 and 80 years. However, the present study focused on adult populations below 40 years of age. Participants underwent a face-to-face questionnaire to collect demographics and data on cardiovascular history/risk factors. Blood pressure and anthropometric measurements were performed in addition to blood tests including plasma creatinine. Renal failure was defined as a GFR &lt; 60 ml/min/1.73 m 2 using the MDRD method adapted to the African population. Continuous data were reported as mean ± standard deviation (SD). Comparisons used the χ2 test for categorical variables and Student’s t test for continuous variables. Multiple logistic regression was used to identify factors associated with CFI, after considering potential confounders. Covariates with significant association (P&lt;0.05) in univariate analysis were included in the multivariate logistic model. Results: Among the 2440 subjects in this study the mean age was 44 ± 15.99, 692 (28%) were male. Among the 1080 participants who were aged less than 40 years old (mean: 31 ± 7.54), 296 (27.4%) were male. Body mass index higher than 25 was present in 32% of the studied population with a significant increase in women (38% vs 15%, p&lt;0,001). The prevalence of hypertension was 28%. The prevalence of renal failure was 3.1% (95%CI: 2.1-4.3%) with a mean glomerular filtration rate of 55 ± 23.58. None of the participants with renal failure had diabetes. Conclusion: This community-based cross-sectional study showed a low prevalence of renal failure in younger participants in Northern Senegal. Further investigations are needed to assess chronic kidney failure and its determinants.